Intended for healthcare professionals

Letters Brief interventions for alcohol in general practice

Encouraging results from the Scottish alcohol brief intervention programme

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1376 (Published 17 March 2017) Cite this as: BMJ 2017;356:j1376
  1. Peter Rice, chair
  1. Scottish Health Action on Alcohol Problems, Edinburgh EH2 1JQ, UK
  1. peter.rice{at}nhs.net

McCambridge and Saitz regrettably make no mention of the Scottish alcohol brief intervention programme in their otherwise authoritative review.1 One of their criticisms is that “uptake is often low.” In Scotland 569 792 brief interventions were recorded as delivered between 2008 and 2015, with an estimated 43% of the potential beneficiaries being reached.2

The Scottish programme lacked a high quality outcome evaluation. We at Scottish Health Action on Alcohol Problems continue to advocate for this, but qualitative analysis has offered important lessons.3

The Scottish programme was established in the context of a broad strategy, with some action on all of the “best buys” of the World Health Organization.4 Encouragingly, some key health indicators have improved over that period, with alcohol related mortality falling by approximately 30%.2 Estimating the contribution of the programme to population health improvement is difficult,5 but it has proved popular with practitioners and policy makers. A funding mechanism linked to standardised training has improved consistency, which is a problem for all verbally based interventions.

Lastly, McCambridge and Saitz’s paper was a carefully considered evaluation of the state of knowledge on a complex problem; the teaser on The BMJ cover—“Alcohol and brief interventions don’t mix”—was not. Some subscribers to The BMJ do not get past the front cover.6 The paper makes a strong case for improvement and evaluation, not for the abandonment of alcohol screening and brief intervention in general practice.

Footnotes

References